States Continue To Formulate Medicaid Expansion Strategies

As the Obama administration gives some states the OK to pursue alternatives to the health law's Medicaid expansion, the shape of the debate in state legislatures changes.

The Associated Press: Branstad Keeps Focus On IowaCare, Not Medicaid
Gov. Terry Branstad is expected to soon reveal his plans for revamping the IowaCare health program for low-income adults, sticking to an approach he holds is better for the state than the Medicaid expansion Democrats are clamoring for. Without details, it's hard to know if a beefed-up IowaCare would solve Linda Cunningham's problems. The 58-year-old, who complains of fatigue and chest pain, said she can't afford the bus ride from her Council Bluffs home to Broadlawns Medical Center in Des Moines, one of just two locations where IowaCare patients can get hospital treatment (Lucey, 3/4).

The Associated Press: Legislators Seek Details On Medicaid Deal
Republican legislators who had resisted expanding Medicaid in Arkansas say they're encouraged by a new plan that would allow funds from the federal-state program to purchase private insurance for the newly eligible, but say they need more details on how such a system would work. The announcement last week that the Obama administration had given Arkansas permission to pursue the plan as an alternative to expanding Medicaid eligibility alters a debate that legislators had said would be the top issue of this legislative session. But state officials and legislators say the idea still has hurdles to face in a majority-Republican Legislature that has generally opposed a straight-up expansion of Medicaid (3/3).

San Francisco Chronicle: Medi-Cal Expansion Will Test Capacity
In less than one year, the Affordable Care Act's promise to bring health care to perhaps 1 million more California residents will be tested. On Jan. 1, 2014, Medi-Cal, the publicly funded health program for low-income and disabled residents, launches a huge statewide expansion. But making a promise is one thing, and delivering is another. In some places, it's already difficult for many poor California residents to find a doctor who is able -- or willing -- to see them. Many medical providers who see these patients say they are overwhelmed, a situation that could worsen when those newly covered by Medi-Cal arrive for care (Bazar, 3/2).

The Miami Herald: Legislature Could Tip Hand On Medicaid Expansion Monday
Gov. Rick Scott has said what he would do. So have the other three members of the Florida Cabinet. But it is the Legislature that will ultimately decide whether the state will expand Medicaid under the Affordable Care Act. House and Senate committees studying the health care law could make their recommendations Monday (Mitchell, 3/3).

The Associated Press/Washington Post: Va. Panel Faces Contentious -- Possibly Litigious -- Task As Brakeman On Medicaid Expansion
There are blue-ribbon commissions and task forces in Virginia government that have done little more than huddle in conference rooms and pack hundreds of pages of dense bureaucratic jargon into binders set on backroom bookshelves or in forgotten archives boxes. There they gather dust for generations. The new Medicaid Innovation and Reform Commission won't have that luxury, provided it survives its infancy (3/3).

In other state news on implementation --

HealthyCal: Months Ahead Of ACA Sign-Up, Outreach Underway
Tracking down Monterey County residents who become eligible for free or discounted health insurance under federal health care reform might take an army. But an army is not what the county will get. Instead, officials are working with their counterparts in Santa Cruz County to land a $500,000 grant (Griffy, 3/4).

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